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From its birth in the Gilded Age to its transformation into social case work in the late Progressive Era, the activities of “scientific charity” typically centered on distinguishing the “worthy” from the “unworthy” poor by a process of “friendly visiting,” and then restricting (or less commonly, dispensing) aid accordingly. To maximize efficiency and to minimize fraud local charity organization societies (COSs;associated charities, in some cities) sought to coordinate and organize all relief-giving across the city, creating conflict with other agencies and, especially, with churches, who resented and feared the COSs’ purported sectarian nature. The movement was also in tension with settlement houses, the other central civic social welfare innovation of the period, although there was something of a rapprochement by the late nineteenth century. By the 1930s, the COSs would win out (becoming, for all intents and purposes, the founders of the social work profession) while settlement houses would all but disappear.

Among the curiosities of scientific charity that have most attracted historians is the shift in the COSs away from a rigid anti-relief ideology and an understanding of poverty that rooted the causes in individual behavior, and toward a more complicated science of social problem-solving and a greater realization that economic and environmental forces beyond an individual’s control might well matter. This may be illustrated best in Josephine Shaw Lowell’s transformation from one of the sternest and sourest anti-relief moralists of the Gilded Age into something of a labor agitator come the turn of the century. To varying degrees, most relevant histories have marked the turning point as the depression of 1893, when misery was so widespread, affecting even the most “worthy” households, that the behavioralist approach became harder and harder to sustain.

Brent Ruswick recounts much of this familiar history, dividing his attention between national activities and trends and local developments in Indianapolis, with special attention to reform leader Oscar McCulloch. One of the virtues of the book is his effort to make more explicit the connection between charity reformers and the eugenicist movement, teasing out some of the ways in which their complementary understandings about poverty came to bear on their respective activities, and why, periodically, they overlapped. Ruswick also wants to push back a bit against the notion that the depression of 1893 marked a strong break in COS ideology, arguing that the transformation was a more gradual one. The ultimate outcome of this transformation, he argues, was nothing less than the disappearance of mass fear of the pauper--the undeserving, irredeemable poor whose very reproduction threatened national well-being.

Although I admire the effort to bring fresh insight into old debates and well-trod territory, I want to make a few observations about what feel like missed opportunities. Ruswick notes the considerable evidence that Oscar McCulloch’s “The Tribe of Ishmael,” a key eugenicist and anti-poor-relief tract, was based on falsified data and profoundly incoherent methodology; the work was, in all likelihood, a sham. It seems to me that the implications of that matter, perhaps profoundly, affect how we think about how Gilded Age/Progressive Era reformers understood poverty, mental illness, deservingness, and charity. It highlights the ways in which the narrative does not quite hold together as well as it might. In the end, we are left somewhat unsure about what the author’s central claims are (although the later sections describing McCulloch’s rejection of much of his earlier diagnoses are strong).

Ruswick is right to want to complicate explanations of the late-century change in COS approaches, but I wonder if he places too much emphasis on ideology and philosophy and not enough on material circumstances. The 1893 depression forms a key turning point in other COS narratives, my own included (The New Victorians, 2004), not simply because of the calamity it brought on, but because it happened at the end of a (largely successful) decades-long effort by the COSs to abolish or reduce outdoor relief in major cities throughout the United States, as Ruswick notes in passing. When the depression hit, even the paltry programs of aid that had been available during the lesser crises of the 1870s and 1880s were unavailable, and private charity was utterly overwhelmed with increasingly urgent demands for aid, so urgent that many COSs engaged in radically expanded programs of cash relief with radically reduced investigation. A greater attention to questions of political economy would help, perhaps, offer a more thorough-going and satisfying account of these events.

Similarly, in wanting to complicate the narrative about the late-century change in COS thought (which is all to the good), Ruswick risks offering his own one-dimensional story, trying to argue broadly that “reformers were at least half-awake to unemployment’s importance at least a decade” prior to the events of 1893 (p. 90). But what’s missing is that some reformers were, indeed, focusing on jobs, wages, health, and living conditions (like their settlement house counterparts), while others were still resolutely focused on the moral failings of poor (immigrant) families. Oscar McCulloch may well have been one of these early pioneers, but was he an anomaly? To tell the story that Ruswick seems to want to tell, one I would like to read, a network analysis of some kind might be called for, in which we seek to more systematically trace the connection of various reformers and agencies and chart their various influences. That is part of a broader complaint I have about methodology and the structure of the book’s argument: there are, for my tastes, too many bold claims without the evidence to support them, and a compressing of historical events across decades that can sometimes render the narrative not only hard to follow, but sometimes hard to identify. That’s frustrating, because there are many exceedingly good questions lodged here, and at times it feels as if Ruswick wants to offer something like a genealogy of scientific charity philosophy, which would make for a fascinating study. But the organization of the book does not serve that larger purpose as effectively as it might; that often feels more like an editorial problem than an intellectual or substantive one.

Almost Worthy offers a lot of interesting detail pulled from COS case files, professional conference proceedings, journals of the field, and more; some possibly fruitful hypotheses about what to make of changes in COS approaches over time; thoughtful new propositions about the relationship between scientific charity and eugenics (including some charity reformers’ apparent remorse); and a fresh, new mini-biography of Oscar McCulloch interspersed throughout. It ultimately stops short of bold new purchase on what is already a sizable literature--a tough standard, to be sure. But for an example of the new insight that can still come from the reading of old case files, see Mark Peel’s Miss Cutler and the Case of the Resurrected Horse (2011).